RENAISSANCE PHYSICAL THERAPY LLC NPI 1396770400

NPI Information

NPI: 1396770400
Provider Name: RENAISSANCE PHYSICAL THERAPY LLC
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
30200 SCHOENHERR
WARREN, MI
ZIP 48093
Phone: (586) 775-5267
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RENAISSANCE PHYSICAL THERAPY LLC is a rehabilitation clinic center in Warren, MI. RENAISSANCE PHYSICAL THERAPY LLC NPI is 1396770400. The provider is registered as an organization entity type.

The provider's business location address is:

30200 SCHOENHERR
WARREN, MI
ZIP 48093
Phone: (586) 775-5267
Fax: (586) 775-2331

The provider's authorized official is Rahat Malik .
The authorized official title is Administrator and has the following contact phone number (586) 775-5267.

The enumeration date for this NPI number is 7/11/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4792395	MEDICAID	MICHIGAN
2	71010000030669	OTHER	MICHIGAN	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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